I was wondering if everyone experiences side effects with Nal when they start? I just got my RX for it yesterday and haven't used it yet. I will probably start tomorrow night and wanted to know what I should expect. What kind of side effects does everyone have? How long will they last? Is there anyone that hasn't had side effects?

Most people have significant, but temporary, side effects. They include nausea, drowsiness, sleep disturbance and feeling "spacey." Take a half pill the first time on a full stomach. If side effects are bad, keep taking a half a pill until they are manageable. For some, the side effects are a nuisance; for some, debilitating, for others, non-existent. But for everybody, they go away, almost without exception.

Thanks, Minneapolis. I'm a little nervous about taking my first one. My doctor advised that I take the full 50 mg. but I think I will follow your advice the first couple of times and take just the 25 mg. and see how it affects me. Do the side effects start right away?

No need to be nervous. Naltrexone is a benign, FDA-approved, drug. Yes, side effects happen for most people and occur immediately, typically nausea, feeling "spacey" and/or tired. Take the pill on a full stomach to reduce nausea. Often, side effects are so severe after the first dose that people go to sleep without drinking -- that's what happened to me. But for some, the side effects are minimal. Even though they are often harsh, they go away for almost everybody within the first several doses -- a week or two tops.
Of the 800 members here, there have been one or two who never got over the side effects and had to quit TSM because of them. But this is very, very rare. The vast majority report that the side effects are a nuisance and go away almost immediately after the first few doses.